Comparison of immune reconstitution after allogeneic vs. autologous stem cell transplantation in 182 pediatric recipients

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is a life-saving procedure for children with a variety of malignant and non-malignant conditions. However, even if immune reconstitution after HSCT has been studied in extensively, until now data on the comparison of immune reconstitution after autologous vs. allogeneic HSCT is scarce, but might provide important clinical implications. Patient and methods: We examined immune reconstitution (T-, B-and NK-cells) at defined time points in 147 children who received 182 HSCT. Differences in the time course of immune reconstitution were analyzed in autologous vs. allogeneic HSCT. Results: We identified a quicker immune reconstitution in the T-cell compartment, especially in the CD4 and naïve subset after autologous HSCT, whereas recipients of allogeneic transplants showed a higher TCRgd proportion. B-cell reconstitution showed a delayed immune reconstitution after allogeneic HSCT in the first two years after HSCT. However, a reconstitution of all lymphocyte subsets after HSCT could be achieved in all patients. Conclusion: Children undergoing a HSCT show a different pattern of immune reconstitution in the allogeneic and autologous setting. This might influence the outcome and should affect the clinical handling of infectious prophylaxis and re-vaccinations.

Keywords

• Stem cell transplantation
• Immune reconstitution
• Pediatric patients